Functional and quality-of-life outcomes of transoral robotic surgery for carcinoma of unknown primary

Abstract

Objectives/Hypothesis To determine speech, eating, aesthetics, social disruption, and overall quality-of-life outcomes over a year period in patients who underwent transoral robotic surgery as part of carcinoma of unknown primary diagnosis and treatment. Study Design Observational prospective study. Methods Twenty-two patients who underwent transoral robotic surgery for the management of carcinoma of unknown primary were included. Patients prospectively completed the Head and Neck Cancer Inventory during a preoperative visit, and at 3-week, 3-month, 6-month, and 12-month postoperative visits. Patients’ demographic, pathological, and follow-up information were also collected. Results The mean follow-up time was 19.8 months. There were overall declines in all quality of life scores during treatment period, which was followed by a continuous recovery. The scores immediately after transoral robotic surgery (3 weeks) were significantly higher than the scores after conclusion of adjuvant therapy (3 months) in multiple domains (P <.05) and the 6-month scores in speech (P = .02) and eating (P = .008) domains. All scores, except for eating (P = .01) returned to pre-treatment levels at 1 year. Patients with detected primaries displayed similar quality-of-life scores compared to patients with occult primaries. Human papillomavirus status and type of adjuvant treatment had no significant impact on quality of life. Conclusions Transoral robotic surgery is a promising, minimally invasive procedure for the surgical management of carcinoma of unknown primary. Patients maintain high functional and quality-of-life status at 1 year after surgery.

Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer

“…The mean 15D score in this study was in the same range as shown in patients with colorectal [20] and prostate cancer [21]. Previous studies on oncologically treated head and neck cancer patients show that a decline in HRQoL is usually seen during the first 3 months after treatment onset, but it then gradually improves towards 12 months [8,22] and even 5 years after treatment patients are satisfied with their QoL [23]. This trend of improvement was also obvious in our study.…”

“…In their study, patients were recruited even after one completed survey at any point of treatment and therefore no knowledge of change in QoL during treatment was shown. On the other hand, Durmus et al [22] showed HPV status to be insignificant in relation to QoL. In our study, the HPV/p16 status was not available for all patients with oropharyngeal cancer.…”

“…Also the treatment in these cases cannot be planned according to a specific site. Durmus et al [22] studied QoL after the diagnosis of carcinoma of unknown primary in patients undergoing transoral robotic surgery (TORS). They showed that QoL scores immediately after TORS were significantly better than after adjuvant therapy but no difference was observed after 12 months.…”

Transoral Robotic Surgery Alone for Oropharyngeal Cancer

“…11,12 The survey also includes 3 global QOL scores. Scores for each domain range from 0 to 100, with 100 being the best functional outcome reported by the patient.…”

Impact of the 8th edition of the UICC TNM classification on staging and survival in patients with neck metastases of unknown primary tumor

“…According to the review by Fu et al [43] the overall complication rate of TORS/TLM was low (7%), but not zero. Moreover, a significant decline in multiple QOL domains such as speech, eating, aesthetics, and social disruption has been recently demonstrated up to 12 months after TORS [47].…”